The Reality of Health Care (or Lack of It) for America’s Poorest

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The reality of health care in America is rather grim. Compared to our foreign counterparts and prior to the Affordable Care Act, America was one of the few developed countries that lacked a form of universal health care. In Advanced Biology this year, we read Rebecca Skloot’s The Immortal Life of Henrietta Lacks, which showed the complexities between biomedical ethics, race, and access to health care. Henrietta Lacks was a black woman who developed advanced cervical cancer and died in 1951. What followed was one of the biggest injustices in medical history. For a long time, Ms. Lacks was denied recognition for her cell’s contributions to the advancement of medical science, and worst of all, her family was not properly informed about the state of Henrietta’s cells. Despite the multi-million dollar industry that formed from reproducing Henrietta’s cells (called HeLa), the Lacks family received no compensation for decades. Many of the Lacks’ family lacked proper access to health care due to their circumstances. Low income, lack of education, and lack of access to primary health care providers contributed to their failing health. Several family members suffered from high blood pressure and diabetes, two preventable conditions that are unsurprisingly common in Americans today. The Lacks family was just one of several million American families who struggled to find health care prior to 2013.

The Problem

In 2012, 47 million Americans were uninsured and 28% of people were on government sponsored health plans like Medicare and Medicaid (1). For the majority of insured Americans, they found insurance through job benefits. Any institution with over 50 employees has been required to provide the option of private health insurance. Private health insurance provides coverage that extends into workers’ families. For those whose jobs do not offer such benefits, they had to resolve by going insurance-less or by applying for health coverage without the backing of a large institution. There were two major flaws in that system: first, if an uninsured person was to ever get into a health complication which that a hospital (i.e. car accident, disease, child birth), he or she may face economic hardship paying the hospital bills. Secondly, if someone who is not in perfect health applies for insurance, companies had the right to deny coverage for that person. “Pre-existing conditions” such as high blood pressure and diabetes stopped many insurance companies from covering the cost of life saving medicine and treatments (2). The uninsured Lacks family was an example of the problem with the American corporate health care system. If someone was unemployed or below the poverty line, one could qualify for Medicaid. Although Medicaid somewhat helped, Medicaid lacked coverage for essentials like eye and dental care (3). The problem of uninsured people in this country forced many to choose between putting food on the table and sending one’s child to the doctor.

A Solution: Obamacare

Giving credit where credit is due, the controversial and hotly debated Affordable Care Act, also known as “Obamacare,” is a proposed solution to America’s healthcare dilemma modelled after the system in Massachusetts. Politicians from both the left and the right agree that health care reform was necessary to improve the lives of millions of Americans and save billions of dollars. While the term “Obamacare” might make certain Romney supporters cringe, Obama’s name will go down in history for passing America’s first universal health care bill. In the 1,000+ page document, the Affordable Care Act changed the lives of those 47 million uninsured Americans. The most important benefits include federally mandated coverage, meaning that insurance companies can no longer deny customers due to preexisting conditions. Every American is required to have health insurance now, just as everyone who drives is required to have car insurance. For those who chose not to get insured, they must pay a penalty fee of either $95 or 1% of their yearly income. Another great benefit is that children can stay on their parents’ health plans until age 26, allowing them some time to find a stable job which provides private insurance. This landmark bill, of course, introduces several more policy changes, but it would be impossible to discuss them all in a LEO article.

Reality Check

Although the health care system in this country was drastically improved by Obamacare, there still exist many disparities in coverage and results. To this day, there are still several barriers which prevent many disadvantaged families from receiving the health care they deserve. African Americans, for example, suffer much higher rates of death from heart disease, cancer, diabetes, and HIV (4). The term “health disparities” refers to the systematically lower quality of health that historically disadvantaged groups lived with over the course of time. The effects of health disparities are evident throughout America today. Obesity and chronic conditions occur more often in economically disadvantaged places, most of whom contain people of color. Language barriers, lack of adequate coverage (through publically funded Medicaid), and inadequate access to fresh food are all other factors that contribute to health inequities (5). The health care system must quickly accommodate to America’s rapidly changing demographics. This means more nutritional education for America’s youth, along with a combination of other efforts from different places.

Health care is a vastly complicated issue that intersects science, politics, economics, social justice, and ethics. In the United States, health care is not a privilege, but a right. Just like the rights to life, liberty, and the pursuit of happiness, it is the government’s responsibility to protect that right for all people.

Brittany Bing is a VI former from Brooklyn, NY. She enjoys long walks on the beach and listening to underground hip hop. She will be attending the University of Pennsylvania in the fall.